TMPPM 2011 > Gynecological and Reproductive Health, Obstetrics, and Family Planning Services Handbook > Medicaid Title XIX family planning services > Services, Benefits, Limitations, and Prior Authorization > Sterilization and Sterilization-Related Procedures > Facility Fees for Sterilization

2.3.8.6 Facility Fees for Sterilization

Hospital-based and freestanding ambulatory surgical centers (HASCs/ASCs) may be reimbursed for procedure code 55200, 55250, 58565, 58600, 58615, 58670, 58671, or A4264. An appropriate family planning diagnosis code must be billed when reporting facility fees for procedure codes 55200, 58565, or 58670.

Refer to: Form OP.4, "Ambulatory Surgical Center" in the Outpatient Services Handbook (Vol. 2, Provider Handbooks) for more information about ASC billing procedures.